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- Title
The Role of Hyaluronan in Asherman's Syndrome Therapy.
- Authors
Krajčovičová, Renáta; Hudečk, Robert; Ventruba, Pavel; Surgentová, Katarína
- Abstract
Objective: Prospective clinical evaluation comparing the therapy of Asherman's syndrome in patients treated using hysteroscopic (HSK) adhesiolysis with insertion of 100% hyaluronic acid (HA) to a patient cohort with an inserted intrauterine device (IUD) and a control cohort. Design: Primary outcome-treatment for menstrual cycle problems. Secondary outcome-attainment of pregnancy after spontaneous conception within 1 year after the ending of hormonal therapy. Materials and Methods: Sixty patients treated from 1997 to 2014 for Asherman's syndrome (in Stage II and III). Cohort A: Insertion of 100% HA (20 patients). Cohort B: Insertion of an IUD (18 patients). Cohort C: Without insertion of antiadhesion agent (22 patients). Primary and secondary goals were evaluated for all patients after a 3-month hormonal therapy. Results: The normal menstrual cycle was restored in 12 out of 20 patients in cohort A (60.0%), in 10 out of 18 patients in cohort B (55.5%), and 8 out of 22 patients in control cohort C (36.3%). A spontaneous pregnancy within 1 year after the end of the treatment was achieved by 14 out of 18 patients (77.7%) in cohort A, by 6 out of 10 patients (60.0%) in cohort B, and by 6 out of 14 patients (42.8%) in cohort C. Ten patients (55.5%) gave birth in cohort A, 4 patients (40.0%) in cohort B, and 4 patients (28.5%) in cohort C. Given the small number of the included patients, there was no statistically significant difference identified in any of the followed cohorts through the completed statistical analysis. Conclusion: Intrauterine insertion of hyaluronan after the completed HSK adhesiolysis enabled the recovery of the normal menstrual cycle for 60.0% of the patients and improved the implantation rate (77.7%) and take home baby rate (55.5%), compared to the group of patients with insertion IUD and with the control group. (J GYNECOL SURG 31:250)
- Subjects
THERAPEUTIC use of hyaluronic acid; CLINICAL trials; HORMONE therapy; HYSTEROSCOPY; INTRAUTERINE contraceptives; LONGITUDINAL method; EVALUATION of medical care; PREGNANCY; TREATMENT effectiveness; ASHERMAN'S syndrome
- Publication
Journal of Gynecologic Surgery, 2015, Vol 31, Issue 5, p250
- ISSN
1042-4067
- Publication type
Article
- DOI
10.1089/gyn.2014.0129